The Nobel Prize versus traditional Chinese medicine

Last week, in response to the awarding of the Nobel Prize in Physiology or Medicine to Chinese scientist Youyou Tu, who isolated Artemisinin and validated it as a useful treatment for malaria back in the 1970s, I pointed out that the discovery was a triumph of natural products pharmacology, not of traditional Chinese medicine (TCM). So did Scott Gavura, a pharmacist who blogs at my favorite other blog, Science-Based Medicine, who also emphasized that the path from TCM remedy for fever to pill used to treat malaria was the very model of how pharmacologists isolate medicines from plants. Basically, we both noted that Artemisinin is extracted from wormwood, but that the process of turning it into a drug involved a lot of trial and error, the elucidation of which wormwood plants contained enough Artemisinin to be useful for manufacturing larges amounts of it, and chemical modification fo the compound to make it more potent. None of this had anything to do with the basic ideas at the heart of TCM, such as the five elements or the imbalances in heat, damp, and the like to which TCM ascribes the cause of all diseases.
I hadn’t planned on writing about this again unless some quack wrote a particularly juicy and stupid bit of nonsense about how Artemisinin proves that TCM works and the awarding of the Nobel Prize to Tu was finally an acknowledgement of that. It turns out that I didn’t have to wait for that because there was an article in the New York Times over the weekend about just what I was talking about, the tension in China between TCM advocates who want to claim the Nobel Prize for Artemisinin as validation of TCM and Chinese scientists who will have nothing of these claims. It’s a story about the Academy of Chinese Medical Sciences, where Youyou Tu did her work back in the 1960s through the 1980s and changed the course of Chinese science. The article lays out the essential conflict quite starkly:

Traditionalists say the award, in the “physiology or medicine” category, shows the value of Chinese medicine, even if it is based on a very narrow part of this tradition.

“I feel happiness and sorrow,” said Liu Changhua, a professor of history at the academy. “I’m happy that the drug has saved lives, but if this is the path that Chinese medicine has to take in the future, I am sad.”

The reason, he said, is that Dr. Tu’s methods were little different from those used by Western drug companies that examine traditional pharmacopoeia around the world looking for new drugs.

Why, I wonder, would Changhua be sad that Youyou Tu helped bring TCM into modern times? The answer is obvious. He believes in the whole system. That includes the whole set of prescientific concepts upon which TCM is based, including the five elements, which are believed to be the five aspects of qi, the life force or energy. Much like the case with the four humors in what I like to call traditional European medicine (i.e., humoral theory), it is “harmonious” balance between the elements that TCM teaches to be the basis of health. There are also six pernicious influences, the six excesses, or the six evils (e.g., wind, cold, heat, dampness, dryness) that are blamed for disease. There is also the concept that one can unblock blockages in the flow of qi using acupuncture needles.

And that’s the problem. TCM is loaded with mystical pseudoscience. There are the vitalism behind the concept of qi, four humors-like nonsense of the five elements, and diagnostic silliness like tongue diagnosis, which is a lot like reflexology for the tongue, where specific areas of the tongue are claimed to map to specific organs, the way reflexology maps areas on the soles of the feet and palms of the hands to specific organs. Don’t even get me started on pulse diagnosis. Yes, assessing the pulse can be a great aid in determining if a patient is dehydrated, possibly septic, or suffers from a heart condition that leads to irregularities in the heartbeat, but that’s not what pulse diagnosis is about in TCM. There are 29 types of pulse in TCM pulse diagnosis, none of which really correlates convincingly to any physiological condition. There are notations such as how a “hesitant” pulse shows that “Blood and essence failing to nourish the meridians. Blood is not flowing smoothly.” Physiologically, this is meaningless. As Steve Novella put it, pulse diagnosis and other aspects of TCM are excellent examples of knowledge disconnected from reality.

Now, of all the aspects of TCM, the one aspect most likely to produce useful treatments is the herbal medicines, for the simple reason that plants can contain chemicals that can be drugs. That’s it. That was the case with Artemisinin, but I note that it took Tu’s screening over 2,000 TCM herbal remedies for activity against the parasite that causes malaria. She tested various ways of extracting it from the plant. She chemically modified it. She had to figure out how to make it into pills. All of that is very different from this:

But the most sophisticated part of Chinese medicine, Dr. Liu said, involves formulas of 10 to 20 herbs or minerals that a practitioner adjusts weekly after a consultation with a patient. And yet almost no research has been done on how these formulas actually interact with the body, he said. Instead, the government has poured money into finding another Artemisinin — with no luck.

“Are we truly respecting this cultural heritage?” Dr. Liu said. “When we think Chinese medicine needs to be modernized and the path it shall go down must be like Tu Youyou’s path, I think it is a disrespect.”

Here’s the problem. From a medical standpoint, the vast majority of TCM desn’t deserve respect. We might respect it from a cultural and historical standpoint, but medically it’s a prescientific system of medicine not based on science. If everything not rooted in science were to be stripped from TCM, all that would be left is the herbal medicine—and then only a small proportion of it, the herbal remedies that have thus far been shown by science to have uses, so far a vanishingly small number. It is that small part of TCM that might have value—if “modernized” and taken down Youyou Tu’s path—that TCM advocates point to as proof that TCM as a system of medicine works.

Indeed, this is what some Chinese scientists themselves say:

But many Chinese think it should not be respected at all. Scientists like He Zuoxiu, a member of the prestigious Chinese Academy of Sciences, say that the ancient pharmacopoeia should be mined, but the underlying theories that identified these herbs should have been discarded long ago.

“I think for the future development of Chinese medicine, people should abandon its medical theory and focus more on researching the value of herbs with a modern scientific approach,” Dr. He said in an interview.

These radically different views on Chinese medicine go back at least a century, and get to the heart of how modern China sees itself.

It’s been discussed in detail how Chairman Mao Zedong retconned the history of TCM in order to make it more palatable to his people after his Communists took the country over in 1949. What was a mish-mash of many different folk medicine traditions that included bloodletting as a precursor to acupuncture was transformed into a single system of medicine, which Mao sought to “integrate” with “Western medicine.” One thing that the NYT article points out is that Mao also demanded that TCM “modernize,” which it tried to do by setting up traditional Chinese hospitals, schools and research facilities like the academy in Beijing. After Mao’s death, however, China invested far more heavily in “Western” medicine:

But money has flowed overwhelmingly toward Western medicine. In the Mao era, rural health care workers — “barefoot doctors” — were often traditional practitioners, which raised the profile of Chinese medicine. After Mao’s death and with growing prosperity, the government doubled down on Western medicine.

Today, China has 1.1 million certified doctors of Western medicine, versus 186,947 traditional practitioners. It has 23,095 hospitals, 2,889 of which specialize in Chinese medicine.

“It’s part of the nation, but the nation of China defines itself as a modern nation, which is tied very much to science,” said Volker Scheid, an anthropologist at the University of Westminster in London. “So this causes a conflict.”

In China, it would appear that TCM is dying. Fewer and fewer aspiring practitioners are becoming TCM practitioners; they want to become doctors instead. The government supports scientific medicine more than TCM. TCM advocates know it, which is why they latch on to this Nobel Prize to reassure themselves that it isn’t so, that TCM is scientific, that it is now respected and embraced.

The sad thing is that China is moving in the right direction. In the “West,” with the rise of “integrative medicine,” which often wholeheartedly embraces TCM, we are going in the wrong direction.

103 Comments

As a nuclear engineer and designer of Autonomous AI systems I have learned that the western method of scientific analysis is too narrow and inflexible to serve average society fairly. Western medice shows me mostly a failure of the scientific method. TCM offers a wealth of knowledge you might want to spend more time understanding because it has saved many more lives than it’s killed and western medicine can’t say that.

Science-based medicine does have negative points too. Within a herbal medicine there are a vast number of pharmacologically active chemicals, working together to solve the problem. However, in science-based drug discovery it is difficult (costly!) to get multiple chemicals approved for use. In this case, probably 10-20 different chemicals in wormwood would have been identified as efficacious in the treatment of malaria, but only the best one brought forward for human trials.

[TCM] has saved many more lives than it’s killed and western medicine can’t say that.

Are bears’, tigers’, rhinos’ and deers’ lifes accounted for, in your tally?
Because the harvest of these animals’ ingredients is often plain torture, and it’s happening as we speak.

“Western” medicine had a period like this not so long ago, but we put some effort since last century into improving the ethics of everybody involved.
And at least, whatever we learn from our lab animals, a good part could be put back into veterinarian medicine. TCM cannot say that.

But the most sophisticated part of Chinese medicine, Dr. Liu said, involves formulas of 10 to 20 herbs or minerals that a practitioner adjusts weekly after a consultation with a patient.

And how does the practitioner know what adjustments to make? Is there some systematic approach, or is it a WAG?

And yet almost no research has been done on how these formulas actually interact with the body, he said.

So it’s the latter, then.

No wonder the Chinese are voting with their feet and preferring science-based medicine to TCM. Even though the Chinese at least have the excuse of TCM being part of their culture. Westerners have no such excuse.

And as for our troll:

I have learned that the western method of scientific analysis is too narrow and inflexible to serve average society fairly.

Show us some evidence that your proposed system (of which you have provided no details) actually works better in this regard, and we might listen. But only if your system accepts reality as a constraint. If it doesn’t, it’s guaranteed not to work. I’m not saying that the scientific method is perfect (no system is; life is unfair), but it does accept reality as a constraint, and I am not aware of a better method.

the western method of scientific analysis is too narrow and inflexible to serve average society fairly.

Speaking as a (former) rocket scientist, it looks to me like you’re mixing apples and oranges. Scientific analysis serves science just fine. It doesn’t work as well for the rituals and beliefs that the average population loves, but it doesn’t need to.

You’re certainly correct. Whether chemicals act in a synergistic or antagonistic manner is unknown… but you could have a much more powerful technique for treating malaria held back by the difficulties in bringing a drug to market.

Biological organisms are highly robust. Objectives are approached through multiple pathways to ensure aims can be achieved. A good example is marijuana. The plant produces 57 (when I last looked) psychoactive compounds, rather than solely delta-9-THC.

You’re certainly correct. Whether chemicals act in a synergistic or antagonistic manner is unknown… but you could have a much more powerful technique for treating malaria held back by the difficulties in bringing a drug to market.

Such as?

I mean, obviously, it’s much easier to just believe a treatment has safety and efficacy than it is to demonstrate it. But that’s hardly an argument against going the difficult route.

Biological organisms are highly robust. Objectives are approached through multiple pathways to ensure aims can be achieved. A good example is marijuana. The plant produces 57 (when I last looked) psychoactive compounds, rather than solely delta-9-THC.

It’s not really clear to me how the points made in those four sentences constitute an argument for the superiority of herbal medicine.

I get the “biological organisms are robust and complex — for example, marijuana!” part. But where do the medical applications come in?

Biological organisms are highly robust. Objectives are approached through multiple pathways to ensure aims can be achieved.

True enough. Were I designing a medicinal herb it would contain multiple chemicals that would work synergistically to selectively kill parasites, strengthen the immune system, and leave your breath minty fresh.

However, the primary purpose of these chemicals in the plant are not to benefit you. It is certainly possible that there are chemicals other than the one identified as most effective that would also be great choices (either alone or in combination) for treatment. It may make sense to continue looking into those. However, there’s no particular reason to think that the whole plant will necessarily contain chemicals that work together to solve your problem.

Dr Will
And the marijuana plant’s “objectives” are not similar to those of the person smoking it–so all those varieties of THC can have complex and contradictory effects on a human.

Have you any examples where complex drug mixtures were indeed more effective than a single optimized component? (Hint –it’s not the two that were honored in this Nobel).

As far as marketing goes, in this case it didn’t stop Novartis scientists from making a better drug for treating malaria by modifying the original version of artimisinin. The original wormwood compound exhibited too rapid clearance (very quickly flushed out of the body). Novartis currently donates the drug.

“TCM offers a wealth of knowledge you might want to spend more time understanding because it has saved many more lives than it’s killed and western medicine can’t say that.”

One of the true beginning points for scientific western medicine was began by Dr. Semmelweis. Dr. Semmelweis found that more mothers survived child birth if a midwife attended the birth than if a doctor attended the birth. He found that midwives normally washed their hands before delivering a baby while doctors seldom if every did. It took time for this idea of washing hands before delivering a baby (and at other times) caught on.

Because fewer mothers died during childbirth, the mothers were able too have more children. This concept of washing hands lead to the population boom. Thus we can say that western medicine has saved far more people than TCM every has.

Objectives are approached through multiple pathways to ensure aims can be achieved.

Is your doctorate by any chance from a business school? I ask because I rarely hear such pure MBA-speak. A sentence like that belongs in one of those trendy books about business success–you know, the ones that invariably miss the actual point in order to bolster the author’s preconceived notions.

What we know about artemisinin is that it, and only it, had anti-malarial properties by itself. That’s not too surprising: wormwood is not itself susceptible to malaria, so any anti-malarial effect would be, from its point of view, a side effect. Other compounds present would have other effects, if any. True, some of those effects might be beneficial, but treating malaria–the goal of Tu’s study–was found not to be among them.

I’ll repeat: Artemisinin is accepted as a treatment for malaria because it was found, by the methods of science-based medicine, to be a safe and effective treatment. If and when some other compound derived from TCM herbal treatments is found to be safe and effective for the treatment of some other condition, it too will be accepted as a treatment. As would compounds discovered by any other means.

How deliciously absurd! That the West should be welcoming with open arms the nonsense of ancient Chinese Medicine, having long abandoned ancient Western nonsense – the four humours, etc – at the very same time as China is abandoning historical nonsense and switching to science. Presumably they will be adopting all the egregious pre-scientific rubbish-medicine discarded by the West in the fullness of time.

My bad. Looks like I was semi-autonomous this morning in my own postings and not even cognizant enough to pick up on the first hint by MOB. I’m going to go write “I will not confuse “Touring” with “Turing” one hundred times on the chalk board.

[email protected]: I would have been prepared to believe that the Turing/touring confusion was due to Autocorrect. (Although, trying it here as an experiment, I see that my spell checker doesn’t draw the red line under either version.) I leave Autocorrect turned off, for fear that something very much like that will happen in my writing. I work in a field where papers are normally cited as First et al. (20xx), or First and Second (20xx) if there are exactly two authors, so it’s something I have particular need to watch out for.

I wouldn’t be too sure about China giving up TCM – not when there’s money to be made: look at this article from China Daily: http://www.chinadaily.com.cn/silkroad/2015-10/09/content_22136828.htm.
It even includes the scary paragraph: “The reason why foreigners don’t understand and accept TCM is that they don’t know its mechanism,” Che said. “Each western medicine has an instruction, telling patients its components, function, dosage, mechanism and contraindication, but TCM doesn’t. I want to be a translator of TCM, finding out the mechanism of TCM from the angle of molecular biology, so that TCM can be exported to more countries and benefit more people”.

The reason why foreigners don’t understand and accept TCM is that they don’t know its mechanism

AFAICT the Chinese don’t know the mechanism on TCM either. And I have little confidence that this Dr. Che will find such a mechanism. That’s because much of TCM is based on a pre-scientific understanding of human physiology. So was Western medicine about 200 years ago. And I doubt that TCM comes without instructions–maybe the instructions are contradictory, but they are there. Likewise components, function, and dosage: there may be conflicting theories based on which version of TCM you use, but there ought to be some guidelines there. Mechanism and contraindication, I’ll grant him, are not present in TCM, but he says this like it’s a good thing. Most drugs have circumstances under which you should not use them (or use them with extreme caution)–allergies, for instance, or interactions with other drugs the patient might be taking.

You say the discovery of Artemisinin doesn’t show triumph to TCM and rather it is a triumph of natural products pharmacology. However, the discovery of Artemisinin by Tu You You is ultimately credited to the historical texts in TCM, namely Huang Di Nei Jing and more specifically Zhou Hou Bei Ji Fang. By saying the credit for this discovery is not due to “TCM” you pretty much discredit the same significant historical texts that laid down the foundations of TCM theory as well as hinted to us 2000 years later about Artemisinin.

I don’t think you’re in a position to criticize “TCM” as broadly as you put it because you obviously show no real interest in the history of development and hardship throughout the history of TCM, otherwise you would not criticize TCM theory so lightly as you do. That’s why Tu You You was awarded the Nobel Prize and found a treatment for malaria and you did not. The difference between you and her is that she showed genuine interest and found value in TCM, theory and text.

While you and others like yourself are writing articles that somehow differentiates “TCM” and “natural products pharmacology”, as important and life-changing as it seems, others are discovering modern usages for traditional medicines and treating a disease that affects 300-500 million people each year by taking time to understand TCM theory and reading TCM texts. I think if you spent as much time writing these politically charged articles as reading and understanding TCM, you could have been making new discoveries you could not have imagined.

One last note: don’t tell readers what or who to respect if you yourself are trying to earn respect by putting others down. It never works.

Giving credit to TCM makes about as much sense as crediting Dr. Tu’s mother for the discovery, since she gave birth to her. TCM did not figure out which of their 2000 fever remedies actually worked, nor did TCM figure distill out the single most active ingredient, nor did TCM figure out which strain of the plant actually had useful amounts of this ingredient, nor did TCM chemically modify this ingredient into a form that actually allowed it to treat malaria. And TCM certainly didn’t carry out clinical trials to prove that this drug was safe and effective.

TCM’s only role here was throwing enough random herbs at enough random diseases that something was bound to have an effect, not that TCM practitioners would have been able to recognize it.

Orac made it very clear that he fully supports this sort of research: the mining of TCM literature for the scant few rememdies that actually have some effect, and bringing the full force of Science to bear on those remedies to turn them into safe, proven medications.

It is entirely possible to support that research, without clinging like a diehard fanatic to the 99.95% of TCM that is totally worthless if not harmful, which is exactly what Professor Changhua would like us to do.

There’s one piece of ancient Chinese wisdom that might be useful here, which is the martial arts principle of using one’s opponent’s inertia against him/her.

In this case, something like what Orac said, or something along the lines of “sure, indigenous or ancient pharmacopoeias often point to medicinally useful plants. If you have any herbs you think have medicinal properties, we’d be glad to promote research to find out how and why they work, and turn them into medications that people can use safely and reliably…”

In other words, anyone who wants to be taken seriously is welcome to join our team and play by the same rules as anyone else.

This will rapidly sort out the honest from the dishonest. Even if the honest are misguided, they can be taught. The dishonest will keep sputtering and fuming and exposing themselves for what they are.

I’m still waiting to hear what Mike Adams is going to do with the Nobel news;-)

TCM’s only role here was throwing enough random herbs at enough random diseases that something was bound to have an effect, not that TCM practitioners would have been able to recognize it.

I suspect that Dr Tu would have reached useful results earlier and with less effort if she had ignored the Chinese-herbal pharmacopeia completely and just tested toxic plants systematically.
But the authorities wanted a vindication of TCM, so that’s how she had to work.

I’m still trying to figure out how ‘average society’ is defined. Are we talking mean, median or mode? What are we measuring? Are societies +/- 2 standard deviations from the ‘average’ served better or worse? Is it a standard bell curve or not?

I suspect that Dr Tu would have reached useful results earlier and with less effort if she had ignored the Chinese-herbal pharmacopeia completely and just tested toxic plants systematically.

That is exactly what I was thinking. It is quite conceivable that plants already omitted from the pharmacopoeia, because of side effects like death, would be at least as good or better candidates for killing parasites. Perhaps a decoction of water hemlock or black henbane (both out of season here, but back in the spring). In many cases, testing plant derivatives seems to me to be pretty much testing inconvenient mixtures of ready-made organic compounds. I suppose it is somewhat simpler than starting with a great big bucket of benzene and a box of bits to decorate the rings.

Does TCM even allow for the concept of parasites, at least those that are not macroscopic?

Hardship is irrelevant to whether a theory is valid, or whether a technique works. How long it takes to figure something out is partly chance. Would you call artemisinin less valuable if wormwood had been the first plant Dr. Tu tried?

Also, if you think artemisinin supports the theory of TCM, surely the two thousand useless substances that it also suggested as malaria cures are two thousand equally strong arguments against it.

Contrary to the report in the New York Times, there is zero evidence that the plant from which the parent compound for artemisinin was derived was ever used to treat malaria. But then, when it comes to medicinal plants, the mainstream press rarely get’s the facts correct.

While the discovery of artemisinin emphasizes the value of mining old texts for drug leads, or what is known in pharmacology as pharmacopoeial research, as part of the task, TCM theory is only of value in identifying potential activities.

While it would be absurd to say that TCM has a single “mechanism”, according to various theories applied in the practice of TCM, certain plants are contraindicated, either in combination with others or in certain TCM diagnoses, all of which must be questioned in accordance with scientific evaluations, without which they will continue to be historical novelties of declining acceptance.

@Doug: TCM incorporates any number of western diagnostics, including parasites. Going back centuries, Chinese medicine had concepts of what we known today to be similar to parasites, and ‘toxic’ plants for their treatment.

Even if I don’t know anything about TCM, I am nearly sure that ancient Chinese physicians could not know there was a disease such that, when blood from a feverish patient was examined, it showed ring- or banana-shaped parasites inside red blood cells. Today we call it malaria, using an ancient Italian word.

It is only a coincidence that a chemical derivate of a substance present in one of who-knows-how-many herbs used to treat “fever” is able to cure that disease.

Jordan C @40: You have obviously never read the texts you are talking about. Huang Di Nei Jing, which translates into “The Inner Canons of the Yellow Emperor”, is traditionally attributed to the legendary Yellow Emperor who was said to have to founded the Chinese state around 5000 years ago, but is more likely to have been composed in the Classical era of Chinese history. In any case, it could have been compiled by no later than the Han Dynasty, seeing that it was catalogued in the Book of Han (Han Shu). The Zhou Hou Bei Ji Fang is a later book, written in Jin dynasty, which heavily cites Inner Canon of Bian Que, another medical manual mentioned in the Book of Han. The Artemisium formula, however, had no citation.

Besides, I challenge you to hold onto your admiration after you read some of the other formulas the Zhou Hou Bei Ji Fang lists for treating fevers. Mixing a spider into a ball of food and swallowing it was not the most ridiculous one.

Herr doktor bimler @32, 43: Based on your comments on this and the last article on the topic, I think you might have misread the reports. The Handbook directs the practitioner to steep the plant in water (non-boiling; the book clearly differentiates between boiling and steeping), which suggested to Dr. Tu that perhaps the boiling method of extraction was a problem.

I don’t think it’s efficient to test random plants (particularly random toxic plants, as [email protected] suggests) for anti-malarial activity. If you use crude extracts, there is no reason to think that anti-malarial effects will appear before the test subject is killed by other secondary compounds. If you use purified derivatives, well, that’s an awful lot of chemical separation and trials.
From what I’ve read, I think Dr. Tu’s team did a very primitive meta-analysis by rounding up a bunch of formulas for fever treatments, counted up the number of times each plant occurred in the formulas, and ordered the plants in terms of frequency. If this is the case, they might have identified Artemesium as a strong candidate early in the process.
I think your claim that Dr. Tu’s project was political is unfounded. Based on the Wikipedia entry, https://en.wikipedia.org/wiki/Project_523, the project also had a branch concerned with synthesizing new compounds. This branch wasn’t just for show either, seeing that it resulted in the creation of anti-malarial drugs such as pyronaridine.

Herr doktor bimler @32, 43: Based on your comments on this and the last article on the topic, I think you might have misread the reports. The Handbook directs the practitioner to steep the plant in water (non-boiling; the book clearly differentiates between boiling and steeping), which suggested to Dr. Tu that perhaps the boiling method of extraction was a problem.

The first thing you mention about “5 elements” in chinese medicine is a wrong translation. It’s literally called “5 categories” in chinese language. It was wrongly translated to “elements” due to the old Indo-European alchemy believes which has nothing to do with the Chinese “5 categories”. It’s very sad that nobody questioned the translation.

As to Qi, we cannot prove it exists by using recent technology yet doesn’t mean it’s bullshit. Can you find any solid prove which says it doesn’t exist? This kind of “if I can’t prove it, then it’s wrong” attitude is very unscientific. The same attitude killed countless scientists who said earth is round centuries ago.

One final advice, it’s something a quantum physics professor said in a class. If you want to judge something, learn it thoroughly first. Finding unproven information online to compose an article to support what you believed is superstitious.

Tu’s document clearly said she got the idea about how to extract Artemisinin from a several hundreds years old TCM book, and this method has been one of the medicines which TCM doctors used to treat malaria. According to other TCM doctors, there are several other TCM herbal combinations can treat malaria and even more efficient than using wormwood.

Jerry: “As to Qi, we cannot prove it exists by using recent technology yet doesn’t mean it’s bullshit.” and “One final advice, it’s something a quantum physics professor said in a class. If you want to judge something, learn it thoroughly first”

So is Qi an energy? To see how well you understand energy please tell us what the difference is between kinetic and potential energy, and how they are related.

As to Qi, we cannot prove it exists by using recent technology yet doesn’t mean it’s bullshit. Can you find any solid prove which says it doesn’t exist?

As to magical curative Nurse Fairies, we cannot prove they exist by using recent technology yet that doesn’t mean it’s bullshit. Can you find any solid prove which says they don’t exist? The same attitude killed countless scientists who said earth is round centuries ago.

One final advice, it’s something a quantum physics professor said in a class. If you want to judge something, learn it thoroughly first.

Let’s put this horrendously misquoted Feynman line in it’s full context, shall we?

You’ll have to accept it. It’s the way nature works. If you want to know how nature works, we looked at it, carefully. Looking at it, that’s the way it looks. You don’t like it? Go somewhere else, to another universe where the rules are simpler, philosophically more pleasing, more psychologically easy.

As to Qi, we cannot prove it exists by using recent technology yet doesn’t mean it’s bullshit. Can you find any solid prove which says it doesn’t exist?

Of course, since Qi is not well defined, any proof that it doesn’t exist is trivially “wrong”: “No, that’s not what we mean.”
That’s one reason why the original claimant has the burden of proof: part of the burden of proof is the burden of definition. If ever Qi is shown to exist, the ‘proof’ will carry the definition of what’s being ‘proven’. When and only when such definition is available, the question of ‘disproof’ becomes meaningful.

Come back when you have (a) a definition of some phenomenon of the universe that’s distinguishable from all other phenomena, that (b) has properties that map onto the properties identified with Qi, and that (c) can be repeatedly, reliably demonstrated. Then, we can all look at what you’ve done and figure out what it really is.

As to Qi, we cannot prove it exists by using recent technology yet doesn’t mean it’s bullshit. Can you find any solid prove which says it doesn’t exist? This kind of “if I can’t prove it, then it’s wrong” attitude is very unscientific. The same attitude killed countless scientists who said earth is round centuries ago.

In addition to what was already said by Chris, AdamG and Bill Price :
– We might not be able to measure Qi directly, but we should be able to measure its effects, for example by proving that therapies based on it work ; this effect is measurable.
– Can you tell me the names of the scientists who were killed because they said Earth is round ? And if you can find them, did their detractors really think “if I can’t prove it, then it’s wrong” ?

No offense to the blind, but how can you make those who were born blind truly understand red, blue, green and color in general? Often times, the TCM deniers sound so much like the blind trying to deny the existence, or, more accurately, the experience of color (again apologies to the blind; this is an analogy only).

Worse still, these TCM deniers 1) purposely put on the blinders that make themselves blind to the myriad of evidence (unlike the blind who have no way of seeing color); 2) most of the deniers are not even qualified to make an educated judgment of TCM: If you want to criticize the the string theory as hogwash, you must first have a Ph.D-level in-depth understanding of theoretical physics; you are not qualified to attack it after perusing a few pop science books or spend a weekend surfing the net reading up on they lazy man and the dummy’s guide to theoretical physics. Yet, this is precisely what these TCM naysayers are doing. Which one of you have any true understanding of TCM to qualify you to attack TCM?

(And FYI, to become a qualified TCM practitioner in China, for example, you need to study in a TCM university for 5 years and then have a number of years of residency before you can even apply for a doctor’s license.)

You received several substantive replies pointing out the flaws in your logic.

If you were intellectually honest, or any kind of honest, you could have at least tried to answer the objections offered.

Instead, you just posted the exact same bullsh!t verbatim.

I find that so rude I’m going to answer with equal rudeness. FOADIAF. Sever your connection to the Internet and increase its collective intelligence. Somewhere in the aisles at the local toy store there is a character doll that, when you press a button on its back, recites a series of banal catchphrases from a TV show aimed at children who think fart jokes are the height of humor. Which has more moral integrity, you or that doll? The answer is: the doll, because it is only trying to entertain children – not engaged in a deliberate, dishonest attempt to counterfeit the appearance of adult behavior while subverting it in the most disgusting fashion. If you had the moral integrity of a puke stain, it would be a step up.

AdamG: “scientific method = it doesn’t exist unless you can prove it.” What herr doktor bimler replied was exactly what I was referring. People blindly believed earth was flat at that time, until Columbus proved them wrong by action. But we didn’t see it happening, how can we prove the history is not fictitious? According to AdamG’s scientific method, this part of history didn’t exist. We also can’t see A’s brain, we can’t touch it, feel it, measure it, look at it carefully before we cut his head open, thus A’s brain doesn’t exist.

This quote “If you want to judge something, learn it thoroughly first.” is not from Feynman whom I have never met and can’t prove he existed. It’s from Adam or Alex something. Sorry, I am not a good student and bad in remembering names.

I spent a few years trying to learn how Chinese medicine works after TCM and acupuncture cured my “treatable and controllable only” problems, e.g. asthma and atopic dermatitis. According to my understanding. There are several different Qi’s. Some might be energy, some are not. The Qi’s categorized as Jing Luo Qi is the effect of how different glands interact with each other, it’s not energy at all. This part if Qi’s can be 100% mapped to modern endocrinology and explained more things than the textbook I have. I drew my findings about mapping Shen Jing Qi to the endocrines all the way from kidney to thyroid on a paper, but it’s missing after my partner cleaned up the desk. I will probably drew it again and map other Jing Luo Qi’s when I have long holidays. Because this paper doesn’t exit any more, according do AdamG’s scientific method, I didn’t do any research. My skin is not as white as the paper on my desk, thus I am black?

Jerry – learn to read.
What HDB said is the exact opposite of what you think – he was making fun of your naive acceptance of the Columbus myth and inability to write clearly.

Why is it a myth? Because Columbus was wrong. Pretty much everyone knew the earth was round, and had since the Greeks. The reason they objected to Columbus’ expedition was because they knew he had done his calculations wrong and was going to run out of supplies before he reached China. And they were right! If it weren’t for the coincidence of America being there, Columbus’ expedition would have been a deadly failure by someone who didn’t listen to the people who knew what they were talking about,

It wasn’t going there that demonstrated the earth’s roundness – the Greeks worked it out easily while staying at home. This is how proof works – you notice strange things, make predictions and test them. The roundness of the earth is testable without seeing it, because it has effects on things like lines of sight and shadows. The presence of A’s brain is testable without seeing or measuring it because it allows A to walk and talk.

According to your own test, you should not be judging either history or science.

I got the 2 posts by ORA mixed up and thought my comment did not post. Please see his/her other post for my response. BTW, if all you can do is name calling, this is truly a pathetic place. And angry people and narrow-minded people, per TCM, are prone to the following (in order of likelihood): liver and eye problems (including myopia; no pun intended!!), digestive issues, neck, shoulder and back problems, heart issues (including high-blood pressure), migraines, and skin problems (including slow-healing skin injuries). Now I’m really curious if you have any of the above.

to become a qualified TCM practitioner in China, for example, you need to study in a TCM university for 5 years

And to become a Doctor of Divinity in 13th-century France, for example, you need to study the Trivium for two years at the University of Paris and then advanced study of the Quadrivium for three years.* Therefore angels are real.

* I can’t be arsed looking up the actual curriculum for 1250 because GVH hasn’t earned more than 20 seconds response.

Name-calling due to a mistake you did. Everybody should be sorry and making apologies, not pouring oil on the fire.

Also, there is nothing wrong with being angry at cheaters and con-men. It’s called having some sense of honesty.

And angry people and narrow-minded people, per TCM, are prone to the following (in order of likelihood): liver and eye problems (including myopia; no pun intended!!), digestive issues, neck, shoulder and back problems, heart issues (including high-blood pressure), migraines, and skin problems (including slow-healing skin injuries)

About 90%+ of humanity.suffers at one point of their life of one or more of those.
I am afraid the correlation doesn’t pan out.

Note to the lurkers: this is a typical well effect (as in “falling into the well”), most commonly used in writing horoscopes and other false-prophet systems.
Just utter a few things, seemingly very precise (“you usually are a calm and measured person but occasionally you get angry and lash out”, “you usually watch your budget but sometimes you buy yourself some treats”) but actually fuzzy enough for a lot of everybody to recognize themselves in the description.
It’s a pre-internet form of phishing, really.

@gvh – So please enlighten us. What is the evidence that TCM as a system provides a useful theoretical framework that is well backed by evidence? Does it provide better clinical results than conventional medicine (as practiced in, say, the United States) and if so, how do you know that?

Wow! So at age 4 I was …angry people and narrow-minded people…myopia; ? Who knew a 4 year old could be like that? Also, my cousin, from birth (he got glasses at about 9 months of age). I’m so impressed that TCM knew all that about us! We should have used cures from TCM instead of seeing the eye doctor.

Deb, thank you for pointing out the Columbus myth. I was taught to believe it in school. I didn’t question what was in my history textbook back then because I blindly believed whatever teachers taught me must be true, whatever different must be wrong. I also had this kind of “black or white” mind. Because of my profession is not related to history, I didn’t spend time to update the my history knowledge. I only questioned what medical school taught us so far. I started questioning my education since I suddenly noticed all new drugs in our “evidence based” medicine world only focus on hiding the symptoms instead of doing anything about the real cause of the illnesses, and the patients need to come back for prescriptions until they die. We were indeed taught to find the cause of the problems, but usually only found it half way, the real cause is usually one or two steps further than who we taught to believe.

Btw, does it mean the history about people believed the earth was flat and sun revolved around earth, and killed people who said earth is round and earth goes around sun is actually a myth?

It’s true that I am bad in understanding puns and sarcasms in general, as I always say things as what it really is instead if playing word games which I personally feel it’s ambiguous and time wasting. It’s worse when I only have time to read and type here during my short breaks. I will try to learn some humor to make me type more like a human.

My point of my replies are:
1. Don’t judge a book by its cover. I believe most of you didn’t even have a chance to see a TCM book’s cover. You can go to Amazon and see one now lol. That’s what the quote I used about.
2. If you make your preexisting knowledge becomes prejudice to judge another approach which you don’t really understand and and refuse to learn anything about it. You are confined in your own world and will miss out the chances to broaden your horizon. If I kept my medical knowledge to judge TCM and other medical systems, I would be still coughing and have itchy skin everyday because our “science based medical industry” only have medicine to inhibit my symptoms instead of fixing the real problems. My partner would have already done her heart surgery and needs to get her heart checked every year.
3. If you judge TCM and eliminate it now, you may also eliminate some treasures which we don’t understand how they work yet.
4. From my experience and understanding, TCM is more evidence based than our evidence based medicine. They just use different approaches and words to see the same things. Remember we have 2 approaches to do differentiation?

Here is a test of how well you did to get into medical school, which I assume included some actual science classes like physics: what is the difference between kinetic and potential energy and how are they related?

By the way, I learned the Greeks measured the circumference of this planet in my elementary school in Ft. Ord, CA in the 1960s.

@gvh you are right and wrong at the same time. Angry people indeed usually have more catecholamines, adrenalin, and T3 in there blood, and the chain effects can cause the symptoms as what you mentioned in your post. The reason->result description is correct in both science based and TCM theories.

you asked Antaeus Feldspar to check the symptoms in your reply. This part is not right, as this is the process of using the result to determine the reason. It’s logically incorrect. The symptoms can also be caused by other reasons, the result->reason process is not a one way street. As I know, TCM doctors need to see the patient, check the patient’s tongue, pulse, smell, other things like urine and excrement etc. before saying anything about the diagnosis. Some of them even use modern technologies like MRI and meridian meter (I have one at home as a toy. It’s funny that every time when I connect it to my computer and my computer tells me that I have caught a cold, it’s always right. But my TCM doctor friend says it’s a rubbish). This is where you are not doing right according to the TCM diagnosis procedure and making an overgeneralized comment.

The point is to evaluate your understanding of “energy.” Something that you should expect when you quote a quantum physicist with the words “If you want to judge something, learn it thoroughly first..”

If you want to criticize the the string theory as hogwash, you must first have a Ph.D-level in-depth understanding of theoretical physics

This is not a prerequisite to noticing that unless something shows up at 14 TeV, it’s not going to be able to make any testable predictions about the real world any time in the foreseeable future, for a very specific reason.

Of course, what’s actually considered to be “hogwash” is the hype machine, which has now devolved into Multiverse mumbling precisely because of this. Like Elvis fans, 10⁵⁰⁰ string vacua can’t be wrong. But at least this disaster still lives in the material world.

By contrast, TCM is in a vastly worse position, given that it has the entire enterprise exactly backward. Disease is defined as an imbalance of yin and yang, and the elaboration is all downhill from there. Shen controls mental functioning but resides in the heart. Sound familiar? A symptom of spleen qi deficiency is diarrhea. Is this a characteristic chronic sequela of splenectomy? How does yuan qi get sorted into ying qi and wei qi in this situation? There’s a trivial, definitive test for prodromal measles; how does it compare with a tongue examination and pulse “classification”?

Chris, you asked the same question earlier because you originally thought I agree with Qi was energy. I made it clear that the Qi’s I can understand are the effects of our endocrine system and they are not energy.

Now you are asking it again just because of I quoted what a quantum physics professor said in a class. Don’t you think you should test me some quantum physics questions instead? No matter what my answer is, they have nothing to do with TCM. Even a janitor who was standing outside of the classroom and heard this quote can get inspired by him without understanding anything about quantum physics. The point is DON’T MAKE YOUR KNOWLEDGE BECOME YOUR PREJUDICE.m
M
If I said the other group of qi’s which are not related to endocrine ae actually some dark energy. Would you test my understanding of dark energy or classical physics? Lol

Admit it, you are just making it personal and trying to find faults. If I can’t say everything 100% right, then you are going to make a conclusion that 100% of what I said was wrong. If you can’t answer 2 out of 10 questions correctly in a exam, does it mean you don’t understand the other 8 questions which you answered correctly? When science based medicine was wrong somewhere, we just simply changed whatever was wrong based on the new findings, it’s happening every year, and we will keep doing it in the future. we don’t say the whole system is a rubbish because someone made some mistakes and we were following the same mistake, right? We are judging TCM based on our prejudice and wrong translations. There are things in TCM don’t look right based on our knowledge in our own system, without considering it’s a completely different system, different approaches, different philosophy behind, different language, different tools. How fair the judgements can be?
I only deciphered a small part of qi’s which are related to endocrine system and found this part of TCM is treasure. Can I say the whole TCM is a treasure island? NO! Can I say the other part of TCM is rubbish especially those shen qi, yi qi, zhi qi blah which seems to be more related to psychology at the second glance? Still NO!

So you can’t answer a high school physics question, this kind of points to your general knowledge about science. It is something most people who are accepted into medical school would know (it is fairly important in biomechanical and biochemical systems). You don’t, so now we know the level of your veracity.

I made it clear that the Qi’s I can understand are the effects of our endocrine system and they are not energy.

Because you drew a picture?

The Qi’s categorized as Jing Luo Qi is the effect of how different glands interact with each other, it’s not energy at all. This part if Qi’s can be 100% mapped to modern endocrinology and explained more things than the textbook I have. I drew my findings about mapping Shen Jing Qi [sic] to the endocrines all the way from kidney to thyroid on a paper, but it’s missing after my partner cleaned up the desk.

This does not inspire great confidence in your understanding of endocrinology.

Chris, Can’t you see that I was refusing to fall in your pointless trap? and you made the exact comment which I predicted what you are thinking about. lol
Not everyone are that eager to seek validation from strangers.

Narad, I dew a picture to help me to understand it. What inspired the confidence was the interaction of the glands and the chain effects which I never thought about before.

As to “how does yuan qi get sorted into ying qi” in your reply. I discussed with 2 TCM doctors about it 2 years ago, and I can briefly explain it in the words we all can understand. The whole sentence is actually wrong. It should be when Yang Qi get stored in Kidney Yin (just Yin, no Qi), the Yang Qi will be called Yuan Qi.
First we need to understand Yin and Yang are also categories in Chinese dualism system which is highly integrated with a 3 bits and 6 bits binary math system called Zhou Yi. Chinese categorized everything in pairs and chuck them in the Yin and Yang buckets, e.g they chuck things are hot, bright, noisy, fast to Yang bucket, and cold, dark, quiet, slow to Yin bucket. It’s very similar to the concept of “der” and “die” in German. In this binary system Yang=1 and Yin=0.
When talking about Yin and Yang in human body, Yin means the physical body which you can see, touch, cut, and perform surgery on. Yang means the functions of our organs. Kidney Yin simply means the physical kidney, in the binary system Kidney Yin=101. Yang Qi=010 which actually means the functions, e.g. our heart beats, body temperature, bowel movements…etc. Yuan Qi=101::010=111 which means the functions related to kidney meridian. Storing Yang Qi to Kidney Yin=our lung gets oxygen, digestion system extracts nutrition, heart pumps blood to kidney, and then becomes Yuan Qi, yeah…kidney functions. It’s not the end of story yet.
In the Zhou Yi system, 111 is a special state, because 010(Yang Qi) can easily separate from it’s reservoir, and then all glands related to kidney meridian in TCM system can release the related endocrines back to our lung, heart, muscles, sotmach..etc.
After deciphering the whole esoteric sentence “Yin, Yuan Qi….blah” is actually a common sense which even our children all have learned about it in plain English, isn’t it?

This is actually not even half of the story, but I can only remember that much. One of my TCM doctor friends in the discussion 2 years ago explained a lot about how our organs interact with each other by using the binary system calculation. However the other TCM doctor (mediocre one) knows nothing about it. Don’t ask me about how the binary system works. I didn’t learn it.
According to the TCM doctor who explained it in plain English to me, more than 90% of TCM doctors don’t know anything about it because it’s not taught in university, thus It’s true that most TCM doctors don’t even know what Yin and Yang really are.

First we need to understand Yin and Yang are also categories in Chinese dualism system which is highly integrated with a 3 bits and 6 bits binary math system called Zhou Yi. Chinese categorized everything in pairs and chuck them in the Yin and Yang buckets, e.g they chuck things are hot, bright, noisy, fast to Yang bucket, and cold, dark, quiet, slow to Yin bucket. It’s very similar to the concept of “der” and “die” in German. In this binary system Yang=1 and Yin=0.

I’m aware of what Yin and Yang are, in terms of their philosophical, so to speak, definition, but I don’t find the concept to be particularly useful in terms of describing the world. It’s a projection of random qualities loosely associated with human gender roles onto inanimate objects, concepts, etc.

It’s not even really related to the “concept” of “der and die” (you forgot “das”) in German. Grammatical gender, when it comes to inanimate nouns, doesn’t really have anything to do with properties of the objects themselves; it’s a function of words and sounds and so on. The assignation, at least in Indo-European languages, is really quite random; in German, the moon is masculine and the sun is feminine. In Russian, the moon is feminine and the sun is neuter. In German death is masculine, in Russian it’s feminine. And so on.

Given that the whole yin/yang concept is so much bunkum to begin with, I don’t see how overlaying it with some sort of bizarre mathematical construct is going to result in something that makes any more sense.

*I can’t find the exact quote, and I really ought to be asleep, but I remember reading a few lines of Suzuki Roshi’s – I think it was in Zen Mind, Beginner’s Mind – where he mentions the notion of masculine and feminine energies in the universe or whatever, passivity is feminine and activity is masculine and yadda yadda, and says in so many words, “This is nonsense. Men and women have an anatomical difference. That is all.”

However the other TCM doctor (mediocre one) knows nothing about it. Don’t ask me about how the binary system works. I didn’t learn it.
According to the TCM doctor who explained it in plain English to me, more than 90% of TCM doctors don’t know anything about it because it’s not taught in university, thus It’s true that most TCM doctors don’t even know what Yin and Yang really are.

I was looking forward to making fun of Jerry’s octal-system magical-thinking numerology… but if the vast majority of TCM practitioners do not endorse this intellectual framework, then despite its entertainment value it’s not TCM, and deserves a name of its own.

herr doktor bimler, I don’t have too much time to explain the old Chinese education culture and not an expert about it. Make it short, some TCM knowledge is still kept as their “lineage master and student” secrets. Yes, it’s the same as the Chinese kong fu movies cliche! They don’t share the most essential knowledge outside of the lineage including the students which the master doesn’t like, that’s why their modern universities don’t have any knowledge about the “secrets” which is not so secret, just like the example in my previous reply. But it’s the key knowledge to make a mediocre doctor becomes a good doctor.
Why don’t they share the knowledge? 1. Selfish! They have been using this selfish lineage system for centuries to make only some of them can earn more money. 2. Lazy and stupid students can’t understand it, so why bother. 3. Some of them made the vow that they can’t spread the knowledge.

The TCM doctor told me about this actually is not the only one breaking the rules and spreading the “secrets” for free. He didn’t tell me the reason, but the reason is obviously. Selfish again! The majority of the mediocre TCM doctors are giving TCM a bad name, and he knows TCM will die in these people’s hands eventually. If the TCM doctors who knows the “secrets” don’t release the “secrets” to the mediocre doctors and even western doctors, they won’t be able to make any money as soon as TCM dies. One of the secrets is actually how to translate the esoteric nonsense “yin yang” words back to what it really means in plain language as I mentioned.

JP is right, these yin yang philosophy is nonsense, at least our interpretation of it is nonsense; it’s the same as the world can’t be generalize to only black and white (a lot of ignorant people is still doing it, especially some of us here lol). Does TCM really based on this philosophy because the lineage masters used the nonsense words to describe things? or they had limited vocabularies back in hundreds (or thousands?) years ago, or maybe they just wanted to encrypt the textbooks to prevent knowledge leakage? I don’t think anybody knows.

herr doktor bimler, I really wish that “Jerry’s octal-system magical-thinking numerology” was mine. Unfortunately, I didn’t create it and can’t sell it, and don’t even understand it.
The TCM doctors showed me things in human body which I already know and didn’t know by that “numerology”. He was all correct. Is it coincidence or there is really something in it, or it’s a stage magic he invented to make fun of western doctors? I can only say I couldn’t find anything wrong, and didn’t record a video to do further research to verify it.
There’s one thing probably I should’ve mentioned. He said the math system helped him understand human body, but people still can be a good TCM doctor without learning it, they just need to memorize more stuff to achieve the same level. herr doktor bimler, do you still think it deserves it’s own band name?

I am not defending for TCM. I probably could make a few more dollars if TCM didn’t exist and patients didn’t have any alternative choice. Really, I just don’t want to see our culture becomes so closed minded and judge a book by its cover, judge a completely different system based on our prejudice. This arrogant attitude is already giving us bad names.

Chris, if you withdraw your emotions and prejudice, step back and read what you wrote in a fact based mind, you will notice that you really have a “yin yang philosophy” mind. Unfortunately, most people needs training to achieve it, thus you won’t be able to see it.

I am sorry about that, labeling is also notorious in our culture. It’s causing issues in our society, and sending more people to psychiatric wards. Don’t expect too much, I am just an average people, mate.

I gave you a simple high school level test, and you failed. What emotion? The laughter at you trying to sound all smart like? How is it “prejudice” to point out that you do not have a clue? You are just hilarious.

So, Jerry, it sounds like you, I, Chris, and Herr Doktor Bimler are agreed that what is generally presented as “traditional Chinese medicine” is a farrago of nonsense. The difference is that you think that some people in China are doing something else with the same name, using the words to mean unrelated things, that actually works, only they’re keeping most of it secret.

I suppose that’s possible: but even if it’s true, it doesn’t count as an argument for TCM. Nor does it make me think highly of those people, who would rather leave most of the human race in ignorant misery than share their knowledge–but who at the same time expect us to *respect* them for their hidden knowledge, rather than scorning and condemning them for hiding information that, if they are correct, could save lives.

The difference is that you think that some people in China are doing something else with the same name, using the words to mean unrelated things, that actually works, only they’re keeping most of it secret.

Nor does it make me think highly of those people, who would rather leave most of the human race in ignorant misery than share their knowledge–but who at the same time expect us to *respect* them for their hidden knowledge, rather than scorning and condemning them for hiding information that, if they are correct, could save lives.

In honest parts of the culture, Chinese and Western alike, that sort of information hiding is considered a hallmark of quackery. I call your attention to Stan Burzynski’s behavior.

[…] Circling back to Jann’s article that so riled Dr. Katz up in the first place, I note that her central idea was that, because so much of CAM and “integrative medicine” is based on pseudoscience and quackery, there is little or no evidence of its efficacy for the indications claimed, which leaves its apologists nothing but pointing to the “potential” of CAM. Flowing naturally from that central idea is the observation that that “potential” has never been realized—and almost certainly will never be realized—because there’s no “there” there. CAM is all either pseudoscience or the co-opting and rebranding of perfectly science-based disciplines like pharmacognosy or “nutrition” as being somehow “alternative,” so whatever “potential” CAM might have would come from such rebranded treatments as being CAM rather than medicine. Even then, the results have been disappointing, claims that the recent Nobel Prize in Medicine somehow “validates” traditional Chinese medicine notwithstanding. […]